A letter to the editor titled, “Association of Semaglutide and NAION Reviewed,” was published in JAMA Ophthalmology by Dr. David Klonoff and Atropos Health’s co-founder and chief medical officer Dr. Saurabh Gombar.
Short summary:
Cai et al recently provided evidence about whether the glucagonlike peptide-1 receptor agonist (GLP-1RA) semaglutide is associated with nonarteritic anterior ischemic optic neuropathy (NAION). This is one of several published studies on semaglutide and NAION, with two studies reporting an association, two studies not finding an association, and a recent case series leading to a proposed mechanism.
Based on these reports, the authors asked the following: (1) is the association statistically significant? (2) is the association clinically relevant? The previous studies each used different methods, and in three of the epidemiologic studies, some increased risk was found and this paper explores those differences.
Key conclusions:
Semaglutide provides statistically and clinically relevant benefits in morbidity and mortality in diabetes, obesity, cardiovascular disease, and kidney disease. Although the risk of NAION to patients should be acknowledged, based on the totality of the evidence evaluating this risk, the authors would not recommend a change in how GLP-1RAs are currently prescribed.